Nested PCR for the detection of Aspergillus species in maxillary sinus samples of patients with chronic sinusitis
| Autor: | Małek, Marianna, Bogusz, Bożena, Paluchowska, Paulina, Szuta, Mariusz, Opach, Maciej, Skiba-Kurek, Iwona, Nowak, Paweł, Klesiewicz, Karolina, Budak, Alicja, Karczewska, Elżbieta |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Maxillary sinus Concordance 030106 microbiology Aspergillosis Polymerase Chain Reaction Microbiology Gastroenterology Aspergillus fumigatus Young Adult 03 medical and health sciences Internal medicine Biopsy medicine Humans Sinusitis Aged Aspergillus biology medicine.diagnostic_test business.industry Histology Maxillary Sinus Middle Aged medicine.disease biology.organism_classification Infectious Diseases medicine.anatomical_structure Case-Control Studies Chronic Disease Female business Nested polymerase chain reaction |
| Zdroj: | Revista Iberoamericana de Micología. 35:140-146 |
| ISSN: | 1130-1406 |
| Popis: | Background Fungal rhinosinusitis has become an increasingly recognized disease, being Aspergillus species responsible for most of the cases. Its diagnosis is quite difficult because of the non-specific symptoms and low sensitivity of the current diagnostic methods. Aims An Aspergillus-specific nested polymerase chain reaction (PCR) assay using biopsy specimens taken from the maxillary sinuses was performed in order to assess its usefulness. Conventional diagnostic methods (histology and culture) were also carried out. Methods A case-control study was performed in the Institute of Stomatology, Jagiellonian University in Krakow, between 2011 and 2014. The case group consisted of 21 patients with suspected rhinosinusal mycetoma while the control group included 46 patients with no suspicion of fungal rhinosinusitis. The two-step PCR assay amplified an Aspergillus specific portion of the 18S rRNA gene. Interval estimation of sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated to assess the diagnostic test performance. The agreement between the PCR and the other tests was evaluated using the Kappa coefficient (k). Results Ninety percent of the samples obtained from patients diagnosed with mycetoma yielded positive PCR results. The PCR showed almost perfect concordance with histology (k=0.88). Sensitivity, specificity, PPV and NPV estimates were 90%; 95% CI: (55.5-99.7%), 98.3%; 95% CI: (90.9-100%), 90%; 95% CI: (55.5-99.7%) and 98.3%; 95% CI: (90.9-100%), respectively. One clinical sample showed growth of Aspergillus fumigatus and positive PCR despite the negative histological examination. Conclusions Nested PCR assay is a promising diagnostic tool to evaluate the presence of Aspergillus in the tissue of maxillary sinus from patients with suspicion of sinus aspergillosis. |
| Databáze: | OpenAIRE |
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